Dorsal column mapping for intramedullary spinal cord tumor resection decreases dorsal column dysfunction

Ankit Indravadan Mehta, Cindy A. Mohrhaus, Aatif M. Husain, Isaac O. Karikari, Betsy Hughes, Tiffany Hodges, Oren Gottfried, Carlos A. Bagley

Research output: Contribution to journalReview article

18 Scopus citations

Abstract

Study Design: Retrospective cohort study and technical report. Objective: To demonstrate, through our institutional series of intramedullary spinal tumor resection, the potential avoidance of dorsal column dysfunction after using dorsal column mapping. Summary of Background Data: Surgical resection of intramedullary spinal cord tumors carries significant associated postoperative morbidity. Much of this morbidity is because of dorsal column dysfunction from the dorsal myelotomy. The inconsistency and distortion of anatomic landmarks for a midline myelotomy has posed a significant challenge for spine surgeons. Dorsal column mapping is a relative new technique that may decrease the morbidity associated with operative resection of intramedullary masses. Methods: A cohort of patients operated upon at our institution for intramedullary lesions were retrospectively reviewed. Neurologic examination changes were assessed through clinic notes and chart review. A total of 91 intramedullary tumors were assessed, with 80 patients without dorsal column mapping and 11 patients with dorsal column mapping. Results: In our cohort of 91 patients with intramedullary tumors undergoing resection over the past decade, postoperative dorsal column dysfunction was observed in 45%. Dorsal column mapping decreased the frequency of new postoperative posterior column dysfunction. Patients with dorsal column mapping had a statistically significant decrease rate of new postoperative posterior column dysfunction of 9% compared with 50% for without mapping (P=0.01). Tumor histology was not found to correlate with worsening posterior column dysfunction in patients undergoing tumor resection. Conclusions: With our surgical cohort as an internal control, we found a decreased rate of postoperative posterior column dysfunction when using intraoperative dorsal column mapping. Our findings show the ability of this evolving technology to provide useful intraoperative information to localize the physiological midline and decrease the rate of posterior column dysfunction after intramedullary spinal cord tumor resection.

Original languageEnglish (US)
Pages (from-to)205-209
Number of pages5
JournalJournal of Spinal Disorders and Techniques
Volume25
Issue number4
DOIs
Publication statusPublished - Jun 1 2012

    Fingerprint

Keywords

  • astrocytoma
  • dorsal column mapping
  • ependymoma
  • intramedullary spinal tumors
  • neuromonitoring

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Orthopedics and Sports Medicine

Cite this